There’s gluten free this and gluten free that in the grocery store….cookies, breads, muffins, pasta, cereals, cakes….is it any better for you?
That’s a valid question that a lot of people wonder about. Generally hot nutrition topics are met with a variety of emotions in the public ranging from fanatical advocates to those aggressively opposed…everywhere you look on the internet will tell you something different!
What do dietitians think? We base our opinions on facts. So let’s look at some!
1. First of all, some people legitimately NEED to avoid gluten because they have
a) celiac disease
b) wheat allergy
c) an intolerance or sensitivity to gluten
Gluten itself isn’t a bad thing for the rest of the population.
2. What is exactly is gluten and how do they make something “gluten free”?
Gluten itself is a protein that is found in different grains including wheat, rye, triticale, barley and their derivatives (like barley malt flavouring, soy sauce, etc). When they make a gluten free product such as bread, they are substituting different gluten free grains for the typical wheat ingredients. Usually things like rice flour, tapioca starch, potato starch, etc. More processed versions of these flours need to be used to make a palatable and less dense imitation baked product…making it less nutritious.
Also problematic is that conventional wheat flour is fortified with vitamins and minerals as a population health approach to prevent disease. While some gluten free flours can be purchased fortified, mostly they are not. Therefore I always encourage those eating gluten free to see foods like GF bread, pasta, cereal as a SUBSTITUTE not a STAPLE. They are a fantastic convenience to have around but should not make up a large part of the diet.
3. There are a lot of naturally gluten free foods! Everyone eats them and they are highly nutritious! These include vegetables, fruits, potatoes, beans, nuts, seeds, eggs, meat, milk and milk alternatives, quinoa and gluten free grains like whole grain rice, wild rice, millet and corn.
4. As dietitians we teach people to be intuitive eaters. Eat a greasy meal or a bunch of sugar and how do you feel? Probably pretty crappy. Some people eat gluten containing foods and feel crappy too. Why is this? Research is linking the types of carbohydrates in gluten containing foods (as well as certain fruits, vegetables, beans and milk products) with irritable bowel symptoms such as gas, bloating, diarrhea or constipation and stomach pain. Other body symptoms include a “foggy mind”, headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia. The reason for those symptoms is still a topic of debate but may have an inflammatory cause in some people.
I used to be a skeptical dietitian about how gluten could make you feel “bad” until my husband was diagnosed with celiac disease last year and we needed to cut gluten out of our household. I began to notice how much better my stomach was feeling, how much clearer my mind was and other symptoms that I didn’t even know I had started to improve! It was such a dramatic change that I went to get screened for celiac disease (negatively)…and my symptoms have resolved since removing gluten from my diet again. Therefore I fit the criteria for non-celiac gluten sensitivity.
Meaning – if you have symptoms while eating gluten that resolve when you remove it from your diet AND you screen negative for celiac disease, it’s called non-celiac gluten sensitivity (NCGS). The symptoms are very similar however there is no intestinal damage or malabsorption in NCGS as seen with celiac.
5. If you cut out gluten and start to feel better, get tested. I really can’t over emphasize the importance of getting screened for celiac disease if you notice an improvement in your symptoms on a gluten free diet. The catch with the testing is that you have to be EATING GLUTEN (a significant amount, equivalent of ~4 slices of bread everyday, for 4-6 weeks) in order to have a positive test result if you have celiac disease.
Being properly screen for and/or diagnosed with celiac disease is important because…
a) It ensures your symptoms are not another medical condition (like inflammatory bowel disease, colon cancer, allergy or another autoimmune disorder)
b) You get the appropriate follow-up from a gastroenterologist (ensures your nutritional markers, liver enzymes, other blood levels and bone density is normal)
c) Makes you take gluten free eating very seriously. It makes the difference between avoiding gluten MOST of the time and being as careful as you need to be with cross contamination at home and eating out. There is no treatment (at this time) for celiac disease other than strictly avoiding gluten for the rest of your life.
d) Minimizes risk of celiac disease complications such as osteoporosis, small bowel cancer and other autoimmune diseases if you are strictly following the diet
e) To make sure you family members get screened! There is up to a 20% chance a first degree relative also has celiac disease!
f) You get a tax break! (In Canada)
Bottom line? Gluten free processed foods, like bread and cake, aren’t any healthier for you than conventional ones unless you need to eliminate gluten from your diet. If you think you have a gluten issue….talk to your doctor about getting tested!